| Original Articles : A phase II study of etoposide (VP-16), ifosfamide, and carboplatin combination chemotherapy plus concurrent thoracic irradiation for limited stage small cell lung cancer |
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Yuna Lee, Sang Jin Lee, Young Nam Kim, Seok Ho Lee, Sun Young Kyung, Eunmi Nam, Se Hoon Park, Chang Hyeok An, Soo Mee Bang, Sang Pyo Lee, Jeong Woong Park, Kyu Chan Lee, Eun Kyung Cho, Seong Hwan Jeong, Dong Bok Shin, Jae Hoon Lee |
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고려의대 구로병원 내과학 교실 |
| 원저 : 국한성 소세포 폐암에 대한 Etoposide (VP-16), Ifosfamide, Carboplatin 복합화학요법과 흉부 방사선의 동시 병합치료 효과 |
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이윤아, Sang Jin Lee, Young Nam Kim, Seok Ho Lee, Sun Young Kyung, Eunmi Nam, Se Hoon Park, Chang Hyeok An, Soo Mee Bang, Sang Pyo Lee, Jeong Woong Park, Kyu Chan Lee, Eun Kyung Cho, Seong Hwan Jeong, Dong Bok Shin, Jae Hoon Lee |
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| Abstract |
Background : Small cell lung cancer (SCLC) is very sensitive to both chemotherapy and radiation therapy. In limited disease of SCLC, the addition of radiation therapy to chemotherapy improves survival and decrease local relapse over chemotherapy alone. This study evaluated the response rate, duration of response, overall survival and toxicity for the combination of etoposide, ifosfamide, carboplatin given concurrently with thoracic irradiation in limited SCLC.
Methods
: Twenty eight patients with histologically proven SCLC who have a measurable disease and previously untreated, were enrolled in this study. Each cycle consisted of VP-16 100 mg/m2 IV days 1～3, ifosfamide 1,200 mg/m2 IV days 1～3 with mesna, carboplatin AUC 6 IV day 1. Cycles were repeated every 21days. Patients received a total of median 6,000 cGy thoracic radiation therapy (180～200 cGy/day) starting on the first day of chemotherapy. Prophylactic cranial irradiation was given to complete remission after chemoradiotherapy.
Results
: The overall response rate in 27 evaluable patients was 93% (41% of complete response, 52% of partial response). The median time to progression was 10.3 months. The median disease free survival was 18.4 months in patients with complete response. The median overall survival was 16.7 months in all evaluable patients. Hematologic toxicities (≥Grade3) of 129 cycles of chemotherapy were leukopenia in 38% and fever with infection in 26%. Nonhematologic toxicities (≥Grade2) of evaluable 27 patients included alopecia in 11%, post-irradiation esophagitis in 44% and pneumonitis in 11%.
Conclusions
: VIC combination chemotherapy with concurrent thoracic irradiation is effective in limited SCLC. It's maior toxicity is myelosuppression.(Korean J Med 70:402-409, 2006)
Key Words : Carboplatin, Chemoradiotherapy Ifosfamide, Etoposide, Small cell lung cancer |
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